Performing Expertise without Experts: Barefoot Doctor Program and Medical Expertise in Rural China

During China’s Cultural Revolution (1966-1976), a large number of lay medical workers— the “barefoot doctors”—were trained and worked in the rural areas as semi-doctors “to provide elements of environmental sanitation, health education, preventive medicine, first aid, and primary medical care while continuing their farmwork” (Sidel and Sidel 1982: 37). American sociologists and public health scholars, who visited China during the 1970s have analyzed its health care delivery quality, focusing on comparing health care systems of China and the U.S. (Sidel and Sidel 1982; Blendon 1979; Rosenthal and Greiner 1982). Recent scholarship has examined the role of the barefoot doctor program in establishing the rural medical system and in introducing western medicine in rural China (Fang 2012; Pang 2017). However, these literatures are often less engaged with the meaning making and interactions among various actors in the barefoot doctor program, and their insights have yet to be brought into theorizing the establishment of the barefoot doctor program as a new network of medical expertise in rural China.

Drawing on the model of “boundary objects” proposed by Star and Griesemer (1989) and the theory of expertise by Gil Eyal (2013), this paper investigates how the barefoot doctor program emerged as a new network of medical expertise in rural China during the Cultural Revolution, with a focus on the collaboration between experts and lay people in the network, as well as the role of the boundary object — A Barefoot Doctors’ Manual. I argue that the success of the barefoot doctor program is a social outcome of the cooperative work among the “alliance” of the heterogeneous participants of the barefoot doctor program, consisting of the state, professional medical doctors, and rural residents. In this network of medical expertise, barefoot doctors work as a key node, bridging rural residents and professional doctors together.